Don’t let government drug the water supply

How 'big data' could drive a new era of compulsory medication

It’s always good to confess your ignorance. So, here’s an example of mine.

I’d always assumed that ‘Lithium’ was a brand name for a psychiatric drug – like ‘Valium’ – and nothing to do with the third element in the periodic table.

I was, of course, wrong about that – lithium in the form of lithium carbonate (or some other lithium salt) is used to treat mental conditions, especially serious depression.

My incorrect assumption was based on another incorrect assumption, i.e. that any substance with a significant pharmaceutical effect would need to be a complex organic compound – either extracted from a plant or synthesised in a laboratory. That a simple mineral salt can be used as a powerful drug was news to me.

Here’s a further twist: lithium salts are naturally occurring, which means that some areas have small but significant amounts of it in the water supply.

Writing for Vox, Dylan Matthews and Byrd Pinkerton explain that this could be having a measurable impact on mental health:

“Are places with more lithium in the water healthier, mentally? Do places with more lithium have less depression or bipolar or — most importantly of all — fewer suicides?

“A 2014 review of studies concluded that the answer was yes: Four of five studies reviewed found that places with higher levels of trace lithium had lower suicide rates. And Nassir Ghaemi, the Tufts psychiatry professor who co-authored that review, argues that the effects are large. High-lithium areas, he says, have suicide rates 50 to 60 percent lower than those of low-lithium areas.”

Correlation is not causation, of course – and using statistics to eliminate other potential factors its a tricky business. Furthermore, not every study confirms the link between naturally lithiated water and reduced suicide risk.

Nevertheless, there are those who believe the evidence is strong enough to justify artificially boosting lithium levels in areas where concentrations are very low:

“Ghaemi and a number of other eminent psychiatrists are making a pretty remarkable claim. They think we could save tens of thousands of lives a year with a very simple, low-cost intervention: putting small amounts of lithium, amounts likely too small to have significant side effects, into our drinking water, the way we put fluoride in to protect our teeth.”

One can only imagine what the backlash to such a policy would be. The conspiracy theorists would have a field day. Putting flouride in water was controversial enough – and that’s only intended to prevent tooth delay. A chemical literally intended to influence our minds would be another matter entirely.

And, yet, if it could save tens of thousands of lives a year it would seem heartless to object. In fact, if it was ‘just’ thousands, or even hundreds, there’d still be a powerful case (assuming the evidence stacked up).

But where do we stop? In an age when big data generating technology allows us to monitor our health on a continuous basis (the ‘quantified self‘) while gathering vast quantities of information about the day-to-day world we live in (environmental monitoring) – we could establish a statistical case for adding hundreds of different substances to the water supply. Must we all be compulsorily medicated to achieve the desired effects?

And what if our big data methods, combined with a growing understanding of the influence of our genes on health outcomes, show that an intervention that benefits one particular group of people is actively harmful to another? How would government decide between these conflicting interest?

As, I’ve written before, the biggest lesson we need to learn from the new genetics (and from medical advances in general) is that government interventions need to be personalised. Drugging the water supply would seem to represent exactly the opposite approach.